1073798815 NPI number — PACIFIC HANDWORKS INC., P.S.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073798815 NPI number — PACIFIC HANDWORKS INC., P.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PACIFIC HANDWORKS INC., P.S.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073798815
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/28/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2800 NORTHUP WAY
Provider Second Line Business Mailing Address:
200
Provider Business Mailing Address City Name:
BELLEVUE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98004-1440
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-827-5877
Provider Business Mailing Address Fax Number:
425-827-5843

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2800 NORTHUP WAY
Provider Second Line Business Practice Location Address:
200
Provider Business Practice Location Address City Name:
BELLEVUE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98004-1440
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-827-5877
Provider Business Practice Location Address Fax Number:
425-827-5843
Provider Enumeration Date:
12/28/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WALKER
Authorized Official First Name:
LISA
Authorized Official Middle Name:
Authorized Official Title or Position:
OCCUPATIONAL HAND THERAPIST
Authorized Official Telephone Number:
425-827-5877

Provider Taxonomy Codes

  • Taxonomy code: 261QR0401X , with the licence number:  OT00003732 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 8943244 . This is a "DEPT OF L&I CRIME VICTIM" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 0188428 . This is a "DEPT LABOR & INDUSTRIES" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 7460507 . This is a "AETNA" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 2082981 . This is a "FIRST HEALTH" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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